Transcutaneous measurement of hemoglobin changes to calculate estimated blood volume change during peritoneal dialysis

• US 10,117,590 B2
• Filed: 06/22/2016
• Issued: 11/06/2018
• Est. Priority Date: 06/22/2015
• Status: Active Grant

• Current Assignee: Fresenius Medical Care Holdings Incorporated (Fresenius Medical Care AG)
• Original Assignee: Fresenius Medical Care Holdings Incorporated (Fresenius Medical Care AG)
• Inventors: Barrett, Louis L., Peterson, David W., Kotanko, Peter
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US15/190,087
• Publication Number:
  US 20160367155A1
• Time in Patent Office: 867 Days
• CPC Class Codes: A61B 2562/0238 Optical sensor arrangements for performing transmission measurements on body tissue
• CPC Class Codes: A61B 5/02042 Determining blood loss or bleeding, e.g. during a surgical procedure
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/14535 for measuring haematocrit
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/6828 Leg
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61M 1/28 Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
• CPC Class Codes: A61M 2205/3313 used specific wavelengths

Abstract

An embodiment of the disclosure provides a method for measuring change in blood volume using a transcutaneous measurement system applied to a patient'"'"'s skin. The method involves placing a sensor in contact with the skin of a patient, where the sensor includes a light emitter and a photodetector. An intensity of light emanating from the light emitter is set and an initial intensity of light received at the photodetector is determined, where the light received at the photodetector has traveled through the patient'"'"'s tissue. A later determination is then made of the intensity of the light received at the photodetector. A change in the blood volume is determined based on the intensity of the light emanating from the light emitter, the initial intensity of light received at the photodetector and the final intensity of light received at the photodetector.

Claims

1. A method for measuring change in blood volume using a sensor comprising a light emitter and a photodetector in contact with a tissue membrane of a patient, the method comprising:

setting an intensity of light emanating from the light emitter and through an optical zone of the tissue;

determining an initial intensity of the light received at the photodetector after passing through the optical zone;

determining a second intensity of the light received at the photodetector after passing through the optical zone, wherein the second intensity is determined at a predetermined time after the determination of the initial intensity; and

determining a change in blood volume of the patient based on the intensity of the light emanating from the light emitter, the initial intensity of light received at the photodetector, and the second intensity of light received at the photodetector by determining;

a first ratio as a ratio between the initial intensity of light received at the photodetector and the intensity of light emanating from the light emitter,

a second ratio as a ratio between the second intensity of light received at the photodetector and the intensity of light emanating from the light emitter, and

that the change in blood volume is proportional to a natural log of the first ratio divided by a natural log of the second ratio.

2. The method according to claim 1, wherein the light emitter is a light emitting diode (LED) and the photodetector is a photodiode.

3. The method according to claim 2, wherein the LED is positioned at a spacing (d) from the photodetector, and wherein d is such that the photodetector is within the optical zone of the LED.

4. The method according to claim 2, wherein the LED emits light at an isosbestic wavelength that is scattered and absorbed by hemoglobin and unaffected by oxygen variation.

5. The method according to claim 2, wherein the setting an intensity of light emanating from the light emitter is:

providing an electrical current at a predetermined current level to the LED, or

providing an electrical power a predetermined power level to the LED.

6. The method according to claim 2, wherein the determining an initial intensity of light received at the photodetector comprises:

receiving an electrical current from the photodiode, the electrical current being proportional to a light intensity sensed by the photodiode.

7. The method of claim 1 further comprising:

sending data containing the change in blood volume to a peripheral device, wherein the peripheral device is configured to send the data through a network connection to a remote server.

8. The method of claim 1, wherein the patient is a dialysis patient and the sensor is placed on the patient'"'"'s arm or leg.

9. A system for measuring change in blood volume comprising:

a sensor comprising at least one emitter and at least one photodetector in contact with a tissue membrane of a patient;

a controller, coupled to the sensor; and

a power supply coupled to both the sensor and the controller, wherein;

the power supply is configured to provide an electrical power to the at least one emitter in the sensor,

the at least one photodetector is configured to provide to the controller (a) a second set of signals indicative of light intensities received at the at least one photodetector due to a first set of signals and (b) a third set of signals indicative of light intensities received at the at least one photodetector due to the first set of signals at a predetermined time after providing the second set of signals, and

the controller is configured to (c) provide to the power supply the first set of signals indicating intensities of light emanating from the at least one emitter, where a number of signals in the first set of signals matches a number of emitters in the at least one emitter, and (d) determine a change in blood volume from the first, second and third sets of signals by;

dividing numbers in the second set of signals by numbers in the first set of signals to determine a first set of ratios,

dividing numbers in the third set of signals by numbers in the first set of signals to determine a second set of ratios,

dividing a natural log of the first set of ratios by a natural log of the second set of ratios to determine an intermediate set, and

determining the change in blood volume as a function of values in the intermediate set.

10. The system of claim 9, wherein the controller determines that the change in blood volume is a median of the values in the intermediate set.

11. The system of claim 9, wherein the controller determines that the change in blood volume is an average of the values in the intermediate set.

12. The system of claim 9, wherein each emitter in the at least one emitter is positioned at a spacing d from a photodetector of the at least one photodetector, and wherein d is such that the photodetector is within the optical zone of said each emitter.

13. The system of claim 9, wherein the controller is coupled to the sensor through one or more trans-impedance amplifiers and one or more analog to digital converters (ADC), and wherein the trans-impedance amplifiers convert electrical current from the at least one photodetector to electrical voltage and the ADCs convert the electrical voltage to a digital signal input to the controller.

14. The system of claim 9, wherein the at least one emitter emits light at an isosbestic wavelength that is scattered and absorbed by hemoglobin and unaffected by oxygen variation.

15. The system of claim 9, wherein each emitter in the at least one emitter is turned on one emitter at a time so that each photodetector in the at least one photodetector obtains the second set of signals and the third set of signals one signal at a time.

16. The system of claim 9, further comprising:

a transmitter, configured to send the change in blood volume to a peripheral device for transmission through a network connection to a remote server.

17. A non-transient computer readable medium containing program instructions for causing a controller coupled to a sensor comprising a light emitter and a photodetector in contact with a tissue membrane of a patient to perform the method of:

setting an intensity of light emanating from the light emitter and through an optical zone of the tissue;

determining an initial intensity of the light received at the photodetector after passing through the optical zone;

determining a second intensity of the light received at the photodetector after passing through the optical zone, wherein the second intensity is determined at a predetermined time after the determination of the initial intensity; and

determining a change in blood volume of the patient based on the intensity of the light emanating from the light emitter, the initial intensity of light received at the photodetector, and the second intensity of light received at the photodetector by determining;

a first ratio as a ratio between the initial intensity of light received at the photodetector and the intensity of light emanating from the light emitter,

a second ratio as a ratio between the second intensity of light received at the photodetector and the intensity of light emanating from the light emitter, and

that the change in blood volume is proportional to a natural log of the first ratio divided by a natural log of the second ratio.

18. The non-transient computer readable medium according to claim 17, wherein the light emitter is a light emitting diode (LED) and the photodetector is a photodiode.

19. The non-transient computer readable medium according to claim 18, wherein the determining an initial intensity of light received at the photodetector comprises:

receiving an electrical current from the photodiode, the electrical current being proportional to a light intensity sensed by the photodiode.